Would I Qualify For Insurance Coverage For An Abdominal Panniculectomy?
Q: Dr. Eppley, I honestly need an abdominal panniculectomy and need a price. I do have Medicare and Medicaid. I live in Indiana. How much do they cover and how much would it cost out of pocket. I get rashes and yeast infections because of it. It hangs down to lower pelvic area.
A: There are two options to consider regarding an abdominal panniculectomy. It can be done through my private practice on a self pay basis as an outpatient procedure. This is the most efficient method to have the procedure performed, as surgery could be done in a matter of weeks at an outpatient facility. All follow up care is done at one of my private offices. The other route is to use Medicare for the procedure. Medicare is primary over Medicaid so it needs to be approved through Medicare. This would need to be done at my downtown Indianapolis office, where you would be evaluated, photographs would be taken and medical records obtained to document the time and number of treatments done to treat the skin infections. To qualify for Medicare coverage the abdominal pannus must be of a certain size (hanging down onto the thighs), rashes must be present underneath it and there must have been a course of at least 3 months of care provided for the skin infections/rash from your doctor. It would take a few months to determine if you qualify.
I would need to see some pictures of your abdominal pannus to determine if Medicare is even an option and I also need some information about your general medical history.
Dr. Barry Eppley